‘‘Pain exposure’’ physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of pain avoidance behavior without the use of specific CRPS-1 medication or analgesics. The aim of this study
was to investigate primarily whether PEPT could be applied safely in patients with CRPS-1.The data from this study do illustrate that this type of therapy is tolerated by patients with CRPS-1.

The study was designed as a preliminary study for a controlled randomized trial and was necessary to determine possible harmful side effects. Because the current standard among many physicians and physical therapists treating CRPS used loading exercises under the ‘‘with pain, no gain’’ concept, this study was a prerequisite for larger trials. Even with the restricted number of included patients, the study was able to demonstrate that no harmful side effects exist, and the power was sufficient to demonstrate that most treatment effects are clinically relevant (MCIC > 30%) and some treatment effects are statistically significant. The clinical implication of this study is that PEPT may now be performed without restrictions with respect to safety. Further randomized clinical trials are necessary to demonstrate the superiority
of PEPT to existing treatment strategies.
This study was financially supported by a grant from the Scientific College Physical therapy (WCF) of the Royal Dutch Association of Physical Therapy, The Netherlands and there is no conflict of interest in this study.

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I am a wife of 41 years and a mother of 2 fantastic adults.In a previous life I was a teacher, painter. To learn more read my interview on HTCwP website.
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